Elizabeth Madva, MD

Pronouns

She/Her/Hers

Rank

Faculty Member

Institution

MGH

BWH-MGH Title

Psychiatrist

Department

Psychiatry

Authors

Madva EN,* Huffman JC,* Sadlonova M,* Harnedy LE,* Longley R,* Amonoo HL,* Feig E,* Millstein R,* Zambrano J,* Rojas Amaris A,* Burton Murray H,* Staller K,* Kuo B,* Keefer L,* Celano CM*

Relationships between positive psychological attributes and irritable bowel syndrome: A systematic review

WMSS 2022

I am an aspiring woman physician-scientist and psychiatrist specializing in the care of patients with disorders of gut-brain interaction, including irritable bowel syndrome (IBS). I was awarded the HMS Dupont Warren fellowship to support the development and preliminary assessment of a positive psychology (PP) intervention to improve well-being and health-related quality of life in IBS patients. My submission describes the systematic review that contributed to the adaptation of the IBS-specific PP intervention that I am currently examining in a pilot randomized controlled trial. I would love the opportunity to present this key step in novel intervention development at the WMSS.

Background

Maladaptive psychological traits are known to contribute to the development and maintenance of irritable bowel syndrome (IBS). Less is known, however, regarding the relationships between positive psychological attributes (PPA) and IBS. Accordingly, we completed a systematic review of the literature examining relationships between PPA and IBS.

Methods

Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria, we systematically reviewed the literature from inception through April 27, 2021. Quality was assessed with the NIH Quality Assessment Tool. A narrative synthesis of findings, rather than meta-analysis, was completed due to study heterogeneity.

Results

Nineteen articles with a total of 3,546 IBS participants met inclusion criteria. IBS individuals report significantly lower levels of PPA (e.g., resilience, self-efficacy, subjective well-being) compared to healthy controls, and these attributes, among others, are associated with physical and psychological health, and health-related quality of life (HRQoL). Resilience was the most common PPA examined. Biological mechanisms, such as hypothalamic-pituitary-adrenal axis dysfunction, may explain relationships between PPA and health.

Conclusions

PPA are lower in IBS patients than in healthy controls, and when present, are associated with improved physical, psychological, and HRQoL outcomes. Interventions to cultivate PPA may have the potential to improve key IBS-related outcomes.